HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater a r t 6 Permit Number: 1 la- G3��
:ar �' = RECER—D DEC 1 n 2016
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Shutter
PROPOSED'111lIPROVEMENT`I:OCATION.
Address: 3200 N Al 410
Legal Description: SEA PALMS UNIT 410 AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID#: 1425-600-0036-000-1 Lot No.
Site Plan Name: Jane Laeth Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED [,) RIPTIONsOF WORK
Install 4 Accordion Shutters
CONSTRUCTION INFORMATIOfV
-, .
Additional wor toa er orme under this permit—c ec a appy:
HVAC Ei Gas Tank ❑Gas Piping �_Shutters ❑Windows/Doors
11 Electric 1:1 Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 2323.00 Utilities: _Sewer OSeptic Building Height: Ifl
OWNER/LESS`EE :._
CONTRACTOR ,
Name Jane Laeth Name: Michael Heissenberg
Address:3200 N A1A 410 Company: Expert Shutters
City: Ft Pierce State:FL Address: 668 SW Whitmore
Zip Code: 34982 Fax: City: Port St Lucie State: FL
Phone No.317-501-1566 Zip Code: 34984 Fax:
E-Mail: Phone No. 772-871-1915
Fill in fee simple Title Holder on next page(if different E-Mail: callexpert@aol.com
from the Owner listed above) State or County License: 16572
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:,;
DESIGNER/ENGI NEER: Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: WalterTillit Name:
Address:6355 NW 36th St Address:
City: Virginia Gardens State: FL City: State:
Zip: 33168 Phone: 305-671-1530 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspec ' n. If you intend obtain financing, consult with lender GJn attorney bef e
commencingwork eco N ice of Commencement.
z�m S
_Signature of Owner/Lessee/Agent Signature of ContractorjlicensHolder
STATE OF FLORIDA 54-,
� � I STATE OF FLORIDA � ]
COUNTY OF COUNTY OF t .
' Vl
The forgoing instrument was ac nowledged before me The forgoing instr ent was acknowledged before me
this 15�—day of Q 20 1�by this I J &day of jQ_CM be r,20 L by
Michael Heissen4g Michael Heissenberg
(Name of person acknowledging) (Name of person acknowledging)
2�� — 0 cvj�
(Signature of Notary Pu lic-State of Flori (Signature of Notary71�011
-State of Flori
Personally Known OR Produced Identification Personally Known Produced Identification
Type of Identification Produced Type of Identification Produced
HEATHER VIZ � � �b A
Commission No pg0.� � Commission No.47i OS� eal) HEATHER VIZZ
NOTARY PUBLIcN;M r , NOTARYPUBLIC
STATE OF FLOR DA (�U :V4.RTATF nF Fi ing I 4
Comma FF976266 •+ - Comte#FF176266
Revised 07/15/2014 s��✓c Expires 11/13/2018 Expires 81/13/2 8
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
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DATE
COMPLETE
INITIALS
IL